Lung cancer cell type as a determinant of bronchoscopy yield

The accuracy of diagnosis of lung cancer obtained by fiberoptic bronchoscopy utilizing sputum cytology and bronchial biopsy depends on the size, location, and number of biopsy samples taken from the tumor. We have found that the accuracy of diagnosis also depends upon the histologic type of cancer. Fiberoptic bronchoscopy (brushings, washing, and biopsies) was performed and sputum cytology and bronchial tissue was obtained from 51 patients with histologically-proven lung cancer. The bronchial biopsy was more sensitive than the bronchial washing and brushing techniques in detecting primary bronchogenic and metastatic carcinoma. It was positive in ten of ten patients with small cell carcinoma, 12 out of 20 cases of squamous cell carcinoma, three of four cases of adenocarcinoma, and three of four patients with large cell cancer. The bronchial biopsy yield was influenced by the histologic cell type with the highest diagnostic yield being found with small cell carcinoma.